Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Los Angeles, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. Although the majority of medical service providers and drug companies are honest and work within the legal channels, some don’t. When fraud happens, everybody can lose. Medicaid and Medicare whistleblower lawyers can help healthcare professionals to submit claims on behalf of the government to report this type of fraud.

The federal and state governments place a great deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, it counts on private citizens in California to come forward to report scams. People like you.

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in Los Angeles, California

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and scams in the market. understand that coming forward is challenging and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our extensive experience representing whistleblowers nationwide, we thoroughly examine your claim, carefully prepare your case, for court, and work relentlessly with you and the federal or state government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Los Angeles, California

Medicaid fraud cost taxpayers countless dollars every year in California. The California False Claims Act permits people who know of Medicaid scams the option to submit a civil complaint on behalf of the state, county, town, public school, or any government agency that has been defrauded.

 

In addition, California is one of just two states in the nation with a qui tam statute that deals with scams executed against private insurance providers. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to submit private qui tam suits against anyone who carries out insurance fraud in the State.

 

Under both laws, it is a civil offense for any private citizen, company, or insurer to send fraudulent claims, misuse public property, deceptively prevent monetary commitments, or returns of funds to the government. Whistleblowers who are aware of such activity can submit a qui tam claim to recuperate the damage done to the government and, in addition, gather a potential financial incentive for doing so.

 

If there is a recovery by the State or other subdivision of government under the California False Claims Act, the whistleblower might be entitled to incentives of in between 15-33% of the recovery. If the lawsuit was prosecuted separately, the whistleblower’s reward potential increases to 25-50% of the financial recovery.

 

If there is a recovery by the state under the IFPA, the whistleblower may be entitled to incentives of in between 30-40% of the recovery if the government intervenes and 40-50% of the recovery if the government does not step in.

Liability of the Defendant in Los Angeles, California

Under the California False Claims Act, the offender may be mandated to pay up to three times the amount of damage to the government in addition to fines of $5,500 to $11,000 per violation.

Statute of Limitations in Los Angeles, California

In California, individuals filing a whistleblower claim under the California False Claims Act must typically submit their problem within six years of the violation, but, there might be extensions in some circumstances.

Working With an Experienced Whistleblower Attorney

If you have learned of deceptive Medicaid activity against the state of California or deceptive activity against a private insurance company, you ought to get the legal guidance and guidance of a skilled whistleblower lawyer. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating scams. Contact us for a completely confidential, no-cost assessment in order to discuss your case.

What is

Medicare Advantage Fraud

Medicare Advantage (MA) plans are privately run healthcare options offering Medicare-eligible individuals additional services that are not included in traditional Medicare. These organizations receive payment from Medicare for each of their members that vary according to their risk adjustment. Some Medicare Advantage organizations overestimate and exaggerate a member’s risk or a patient’s diagnoses to get higher payments from Medicare. They do this by:

Upcoding

The MA provider increases the severity of the patient’s condition, submitting a more serious diagnosis code to get paid by Medicare at a higher rate.

Chart reviews

The MA provider reviews charts to add additional diagnosis codes.

Chart mining

The MA provider mines patient’s charts to look for conditions that are not current but can put as current to increase their payments from Medicare.

Adding unsupported diagnosis

Coders are directed to add codes based on other information in the chart.

Not removing old diagnosis codes

The MA provider increases the severity of the patient’s condition, submitting a more serious diagnosis code to get paid by Medicare at a higher rate.

Sham RADV audits

The MA provider reviews charts to add additional diagnosis codes.

Incentivizing doctors

The MA provider mines patient’s charts to look for conditions that are not current but can put as current to increase their payments from Medicare.

Pre-filling charts

Coders are directed to add codes based on other information in the chart.

If you suspect Medicare Advantage Fraud, you are a healthcare worker in Los Angeles, California, get in touch with us here.

Khurana Law Firm, P.C.
Medicare Fraud
Medicare Fraud is a Serious Problem

While there are no exact figures concerning Medicare fraud, we do know it is a huge problem. In the fiscal year 2020, the government recovered over $1.8 billion in civil and fraud claims relating to the healthcare industry. 

$ 0
Recovered only in 2020
YOU, the healthcare worker, provide the most vital role in combating Medicare abuse and fraud.

Watching for fraud and abuse within your organization, practice, or provider’s office helps protect everyone from this taxpayer drain and holds abusers accountable.

So what is Medicare Fraud?

Fraud, as it relates to Medicare, is when individuals or entities make false statements or representations to benefit themselves at the expense of the Medicare program. 

Who defrauds Medicare?

Medicare fraud can involve numerous individuals, organizations, and entities, including physicians and nurses, physician-owned groups, drug companies, home health providers, medical device providers, nursing homes, and others.

How do people and companies commit Medicare fraud?

Fraud and abuse come in many different forms from coding abuses, to kickbacks, to altering records, to organized crime infiltration. Each method benefits the abuser while costing taxpayers billions. 

What laws protect Medicare from fraudulent activity?

The False Claims Act, Anti-kickback Statute, Stark Law, and Federal Criminal Healthcare Fraud Statute hold abusers accountable for their fraudulent activity. 

What government agencies protect against Medicare fraud?

Many government agencies strive to protect and promote the integrity of Medicare. These include the Centers for Medicare and Medicaid Services, Center for Program Integrity, US Department of Health and Human Services, and US Department of Justice, all attempting to keep Medicare fraud at bay. But they rely on people like YOU to be their eyes and ears.

How can I help?

If you see abuse and fraudulent activity you should report it. In some cases, you may even be entitled to a reward. If you are a healthcare worker in Los Angeles, California,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

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Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Los Angeles, California

If you’ve become aware of fraudulent activity that may involve Medicare or Medicaid in Los Angeles, California, you require the advice of an experienced whistleblower attorney, someone who can ensure that your claim is fully examined and submitted accurately and promptly. By working with a knowledgeable lawyer you are increasing the chance that the government will step in, thus increasing your chances for a reward. Reporting Medicaid and Medicare scams is a complicated matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam attorneys to assist in your battle against Medicare and Medicaid scams. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we may represent you in a qui tam suit to help report the fraud and allow you to gather a financial benefit. All whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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